旋磨术的新时代：澳大利亚视角
A New Era for Rotational Atherectomy: An Australian Perspective.
作者信息
Bamford Paul, Parkinson Michael David, Gunalingam Brendan, David Michael, Lau George Tat-Ming
机构信息
Gosford Hospital, Gosford, NSW, Australia.
University of Newcastle, Newcastle, NSW, Australia.
出版信息
Clin Med Insights Cardiol. 2019 Jun 7;13:1179546819852070. doi: 10.1177/1179546819852070. eCollection 2019.
BACKGROUND
Rotational atherectomy (RA) has been used in percutaneous coronary intervention (PCI) for 30 years. With advances in technology, this observational study looks at how rates of RA have changed over the past decade in Australia in relation to PCI and coronary artery bypass graft (CABG) rates.
METHODS
Retrospective analysis of RA, PCI, and CABG rates per Australian state from Australian Government Department of Human Services' data on Medicare items from 2007 to 2017 was carried out.
RESULTS
There were 149 RA procedures in 2007, increasing to 452 in 2017. Rotational atherectomy accounted for 0.67% of PCI procedures in 2007, increasing to 1.48% in 2018 (+0.81%, 95% confidence interval [CI] = [0.64%-0.91%]; < .001). Most of this increase has come from procedures in New South Wales (441% increase). Australian PCI rate increased from 22 301 to 30 480. Rate of CABG decreased from 5418 to 5206.
CONCLUSIONS
From 2007 to 2017, rates of RA trebled in Australia. This is despite stable rates of PCI and a fall in rates of CABG. There are several clinical explanations for this trend.
背景
旋磨术（RA）已在经皮冠状动脉介入治疗（PCI）中应用了30年。随着技术的进步，这项观察性研究探讨了在澳大利亚，过去十年中RA的发生率相对于PCI和冠状动脉旁路移植术（CABG）的发生率是如何变化的。
方法
对澳大利亚政府人类服务部2007年至2017年医疗保险项目数据中每个澳大利亚州的RA、PCI和CABG发生率进行回顾性分析。
结果
2007年有149例RA手术，2017年增至452例。旋磨术在2007年占PCI手术的0.67%，2018年增至1.48%（增加0.81%，95%置信区间[CI]=[0.64%-0.91%]；P<0.001）。这种增加大部分来自新南威尔士州的手术（增加441%）。澳大利亚的PCI发生率从22301例增至30480例。CABG发生率从5418例降至5206例。
结论
从2007年到2017年，澳大利亚的RA发生率增长了两倍。尽管PCI发生率稳定且CABG发生率下降，但仍出现了这种趋势。对此趋势有多种临床解释。
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